Permit i:
CITY O TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00305
*40 DEVELOPMENT SERVICES DATE ISSUED: 7/29/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00200
SITE ADDRESS: ,16-398 SW 72ND AVE B -08
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: / (e34 4 LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 18 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,700.00
Remarks: TI: office
Owner: Contractor:
PACIFIC REALTY ASSOCIATES RONS HOTEL & RESTAURANT EQUIPMENT S
15350 SW SEQUOIA PKWY #300 -WMI 16364 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224 -7750
Phone:
Phone: 503 - 624 -0890
Reg #: LIC 76335
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[TAX] 8% State Surchar1 6/25/2004 $6.54 Electrical Permit Required
[BUPPLN] Pln Rv 7/1/2004 $53.
Sprinkler Permit Required
[ 11 Framing Insp
[FLS] FLS Pln Rv 6/25/2004 $32.68 Gyp Board Insp
[BUILD] Permit Fee 6/25/2004 $81.70 Final Inspection
(additional fees not listed here)
Total $255.73
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-11 1 hrough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin• 03) 246 -• • •9 or 1- 800 - 332 -2344.
Issue • By: � � 4 i .7 Ce_ca,
Permittee r , i i �
Signature: = / ,-
Call 639 -4175 by 7 p.m. for an inspection the next business day
f 636 f sC' L NV
. f o , J s tfO rez— •
Building Permit Anoligtion : , FOR OFFICE USE ONLY
City of Tigard Received Deem , : - . i� %� ii 117 /.,ice • 0 3Q5
13125 SW Hall Blvd., Tigard, OR 97223 , Plan Revi •
Phone: 503.639.4171 Fax: 503.598.1960 tad d "�;„N1i - 1•' A 1
�� Date/By: , ' /2. itor Other Permit:
,6 �
Inspection Line: 503.639.4175 !� !� i Date Readyn3y: )uric: ® See Attached Checklist for
Internet: www.ci.tigard.or.us : : Cr-, :•:,,,°&,,,,:-. Notified/Method: 77-/e Supplemental Information
TYPE OF WORK REQUIRED DATA 1 - AND 2- FAMILY DWELLING
❑ Demolition Permit fees* are based on the value of the work performed.
❑ New construction Indicate the value (rounded to the nearest dollar) of all
ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
i work indicated on this application. _
CATEGORY; OE CONS RUCTION ; ; \
Valuation: $
❑ 1 - and 2- family dwelling Commercial/industrial
Number of bedrooms:
❑ Accessory building ❑ Multi - family
Number of bathrooms: p
❑ Master builder ❑ Other:
JOB SITE INFORMATION �,A LOCATION Total number of floors:
/4014 Job site address: /4014 „ / . /Al ,/Q New dwelling area: square feet r ,
City/ State/ZIP: a,,,, d 2/ 6 J/U Garage/carport area: square feet
SuitegidDipt. no..:'B _c Project name: &WS' tJ � ?AX Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
, *: REQUIRED DATA COMMERCIAL- USE
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
• DESG RIPTION.:OF Vi'ORK work indicated on this application.
; :0' «� Valuation: $ 4 7Oa
Existing building area: square feet
New building area: square feet
E .. Number of stones
.. ; g PROPERTY OWNER'S . '❑ TENANT '
Name: PacTrust Type of construction: y..
Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups:
City/ State/ZIP: Portland, OR 97224 Existing: A s... A,
Phone: (503 ) 624 -6300 Fax: (503 624-7755 New: t'
r
CONTACT PERSON;.
® APPLICANT . ❑ N OTI C E
Business name: PacTrust All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Pkwy . , Suite 300 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: Portland, OR 97224 apply:
Phone: ( 503) 624 -6300 Fax: : (503) 624 -7755
E -mail:
CONTRACTOR .
Business name: :,;::.i ; BUILDING PERMIT, ;FEES*
Address: Please refer to fee schedule.
City/ State/ZIP: - Fees due upon application
Phone: Fax: ( 503)
_ Amount received
CCB lic 74535— 9/501(
/ Date received:
Authorized signature: 1 , , x . This permit application expires if a permit is not obtained
- / I' within 180 days after it has been accepted as complete.
Print name: ii !�� /4,41/..r,0- Date: 9rlf * Fee methodology set by Tri- County Building Industry
' / Service Board.
i:\ Building \Permiu \BUP -Pe mitApp.doc 12/03 440- 4613T(11/021COM/WEB)
CITY OF TIGARD 24 -Hour
BUIL NG Inspection Line: ,(503).639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP a 016 y - 6 6 .` -2 3.0 5
Received / Date Requested 3/ AM PM BUP
/
Location / 6 3 6 4/ - 7 Suite a'" d MEC
Contact Person Ph (L53 LM
Contractor Ph ( :) l a a y - 7 7 8 1 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Stab Inspection No : - SIT
Post & Beam �'il�✓I %
Shear Anchors /
Ext Sheath/Shear — —1— — ice 1' -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
ivy
11
PART FAIL
• = ING
Post & Beam
Under Slab
Rough -In ��
Water Service
Sanitary Sewer I l�����'
Rain Drains
Catch Basin / Manhole TV'
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE I=1 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART' FAIL